Glucose intolerance and hypertriglyceridemia appear to be frequent metabolic concomitants of chronic uremia. Both these abnormalities are ameliorated but not eliminated by intensive hemodialysis and aggressive treatment of the uremic state. The plasma lipid alteration appears to result principally from disturbances in both the production and catabolism of the triglyceride-rich lipoproteins. The persistence of these well-recognized cardiovascular risk factors may contribute to the accelerated premature cardiovascular disease that appears to devastate chronic dialysis patients.